Trauma exposure and factors associated with ICD-11 PTSD and complex PTSD in the Lithuanian general population.

Monika Kvedaraite,Odeta Gelezelyte,Agniete Kairyte,Evaldas Kazlauskas,Neil P Roberts

doi:10.1177/00207640211057720

Abstract

Background:After the inclusion of a novel diagnosis of Complex Posttraumatic Stress Disorder (CPTSD) in the 11th edition of the International Classification of Diseases (ICD-11), there is a growing need for research focused on not only studying the underlying risk factors of this disorder but also differentiating the risk factors of Posttraumatic Stress Disorder (PTSD) and CPTSD to understand better the factors leading to CPTSD onset and symptom maintenance.Aims:This study aimed to explore the prevalence of traumatic experiences, trauma-related disorders and risk factors associated with ICD-11 PTSD and CPTSD in a population-based Lithuanian sample using the International Trauma Questionnaire (ITQ).Methods:The study sample included 885 participants (age M[SD] = 37.96 [14.67], 63.4% female). The Life Events Checklist was used to measure trauma exposure, PTSD and CPTSD symptoms were measured by the Lithuanian ITQ version. The Disclosure of Trauma Questionnaire (DTQ) was used to measure the urge or reluctance to talk about trauma.Results:The prevalence of at least one traumatic experience in the study sample was 81.4%. The prevalence of PTSD and CPTSD among the general population in Lithuania was 5.8% and 1.8%, respectively. Accumulative lifetime trauma exposure, sexual assault and assault with a weapon were significant predictors for both PTSD and CPTSD. Participants from the CPTSD group reported greater reluctance to disclose trauma and stronger emotional reactions than no diagnosis and PTSD groups. Results also indicate that the Lithuanian ITQ version is a valid measure for screening PTSD and CPTSD in the general population.Conclusion:Previous history of trauma and interpersonal trauma were associated with posttraumatic stress disorders but did not differentiate between PTSD and CPTSD in our study. However, social trauma-related factors, such as trauma disclosure, were associated with stronger CPTSD symptoms.

Highlights

The inclusion of a new diagnosis of Complex Posttraumatic Stress Disorder (CPTSD) in the 11th edition of the International Classification of Diseases (ICD-11) (World Health Organization, 2018) calls for comprehensive research and validation of possible assessment tools and exploration of risk factors to better understand the new diagnosis
We aimed to explore the prevalence of traumatic experiences and trauma-related disorders in Lithuania and risk factors associated with PTSD and CPTSD
In line with the previous studies (Cloitre et al, 2018, 2021; Ho et al, 2019; Owczarek et al, 2020), the Confirmatory Factor Analysis (CFA) results confirmed a correlated secondorder two-factor model to be the best fit, where a secondorder PTSD factor accounts for the covariation between the Re, Av and Th factors and a second-order disturbances in self-organisation (DSO) factor accounts for the covariation between the affective dysregulation (AD), negative selfconcept (NSC) and disturbances in relationships (DR) factors (χ2(47) = 162.62, p < .001; Comparative Fit Index (CFI)/Tucker–Lewis Index (TLI) = 0.970/0.958; Root Mean Square Error of Approximation (RMSEA) [90% CI] = 0.058 [0.049–0.068]; SRMR = 0.041)

Summary

Introduction

The inclusion of a new diagnosis of Complex Posttraumatic Stress Disorder (CPTSD) in the 11th edition of the International Classification of Diseases (ICD-11) (World Health Organization, 2018) calls for comprehensive research and validation of possible assessment tools and exploration of risk factors to better understand the new diagnosis. The most widely used measure for ICD-11 CPTSD is the self-report International Trauma Questionnaire (ITQ; Cloitre et al, 2018). Aims: This study aimed to explore the prevalence of traumatic experiences, trauma-related disorders and risk factors associated with ICD-11 PTSD and CPTSD in a population-based Lithuanian sample using the International Trauma Questionnaire (ITQ). Results indicate that the Lithuanian ITQ version is a valid measure for screening PTSD and CPTSD in the general population. Social trauma-related factors, such as trauma disclosure, were associated with stronger CPTSD symptoms

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